High hamstring tendinopathy takes “tight hammies” to the next level. Running asks a lot of the hamstring muscle. It provides a majority of the force required to slow down our leg as it swings forward with each stride. Especially when we pick up the pace or run hills, this force becomes significant. Over time, repetitive load can overwhelm the tendon at the top of the hamstring and lead to feelings of soreness, tightness, and discomfort. When the tendon itself (not just the muscle) becomes irritated, this is called high hamstring tendinopathy. Today we’ll explain its causes and show you the simple exercises that fix high hamstring tendinopathy in runners.
What is high hamstring tendinopathy?
High hamstring tendinopathy is irritation of the tendon at the top of the hamstring. Runners with the condition might feel pain deep in the back of their upper thigh or nagging tightness in their glute right where it meets the back of the leg. That feeling of tightness may even radiate from the tendon down the back of the thigh.
Ultimately, the cause of high hamstring tendinopathy in runners is simple. You ran more than the tendon was ready for. That could mean more mileage, more hills, more pace, or just more than it could tolerate because you were under-slept, undernourished, or had too little time between workouts. There is nothing wrong with your body structure, your stride, or your shoes, running just hurts sometimes. Thankfully, the best way to get rid of high hamstring tendinopathy is to encourage the tendon to heal itself through increasingly challenging resistance exercises. This can done with minimal equipment and requires no expensive doctors visits.
What happens to the tendon in cases of high hamstring tendinopathy?
When you put more load (mileage, pace, hills, etc) through a tendon that it’s ready for, it panics. The body stops laying down neat and orderly strands of new collagen and begins a disorganized inflammatory response. The body wants to reinforce everything as fast as possible so you don’t really get hurt while also sending pain signals to the brain so you slow down. The way to get it back on track is to introduce the correct amount of load. Gradually introducing the right amount of resistance exercise tells the body that things are OK and retrains it to lay down new strands of orderly, healthy collagen.
Exercises that fix high hamstring tendinopathy in runners.
The best kind of exercises when it comes to hamstring injuries and high hamstring tendinopathy are ones that load the hamstring eccentrically (scientific review). This just means that the muscle is working as it’s getting longer. If you have nagging pain but can still run, begin prehabbing this muscle 3 times per week and gradually increase the number of sets, reps, and weight as you begin to get stronger. If your tendon discomfort is severe and you cannot run, it may be worth consulting with a medical professional. But, if they recommend anything other than progressive strengthening exercises (ie. injections, needling, surgery, or anything that involves tools on your body) it might be worth getting a second opinion!
Exercise 1: SL RDL with weight
Why it works: this exercise has both a concentric and eccentric phase and you can always add weight to increase the difficulty. Don’t feel pressure to use weight or go extremely deep, especially when just beginning a tendon prehab plan! Single leg exercises also help because the pain free leg cant take over.
Exercise 2: Eccentric Bridge
Why It works: This is where the fun begins. The hamstring works only on the eccentric phase and as a result this exercise can be extremely hard on the first go around. Start with a handful of reps and no more than a few sets. Soon, 3 sets of 10 will be easy!
Exercise 3: Nordic Hamstring Curl
Why it works: when it comes to hamstring problems, the nordic curl is the gold standard. Many scientific investigations confirm its effectiveness in solving hamstring problems (review). It’s important to know that this is one of the most challenging exercises in the world. You may only be able to extend a few degrees for a few reps on your first try. Progress gradually and you have a strong chance of defeating your high hamstring tendinopathy. You don’t need to do too many reps to get a strong rehab and protective benefit (study). Here is a video on different ways to secure your feet.
In summary
Fixing high hamstring tendinopathy can take a long time. When tendons get upset it can take months of consistent work to get them happy again, but the result is always worth it. If you commit to a simple program of gradually more difficult exercises, you will be able to get rid of your high hamstring tendinopathy and run pain free. Like all problems in running, it’s just a matter of consistency plus resistance plus time.
You can try these exercises and get a routine with specific sets and reps, in the Recover Athletics app. The Recover App helps runners fix aches and pains and prevent injury. A year’s subscription costs less than one trip to physical therapist and we have an unlimited free trial. Give the app a try today!
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